Why Chandigarh needs group home for mentally ill

Simmi Waraich, Neelu Sarin & Aditya Vikram

Historically, across countries and regions, the rights of persons with intellectual disabilities and mental illnesses have been the last to be achieved. The reasons are not hard to guess — public ignorance, social stigma and discrimination. Finally, in accordance with the United Nations Convention for Rights of Persons with Disabilities (UNCRPD), we have the new Rights of Persons with Disabilities Act 2016, and the Mental Healthcare Act 2017 in India.

The two Acts are a radical departure from the past and for the first time enshrine several fundamental rights for persons with disabilities. One of the most important is the ‘right to community living’, i.e. persons with mental disabilities have a right to live in and not be separated from the community. The two Acts also make it clear that it is the duty of the appropriate government(s) to ensure the fulfilment of these rights.

There is a widespread myth and misunderstanding that persons with chronic disabilities due to mental illness and intellectual disabilities cannot live independently in society, that they might be disruptive. However, most people with psychiatric disorders already live in the community with their parents or caregivers. Regular supervision, medication and socio-occupational rehabilitation help them live as productive members in society. These individuals would require assisted living facilities once their parents/caregivers are no longer around to provide support. The support needs vary from individual to individual — some are capable of independent living with minimal support, others have moderate support needs and still others may need a 24/7 care home. The whole idea of supported/assisted living is very similar to an old-age home i.e. some people are fully independent, some need support and care and their daily routine may need to be supervised. Assisted living is not rocket science; the challenges are not technical or financial, but social — ignorance and stigma.

So how does a society or government ensure community living? What are the various models? How many persons with mental disabilities need assisted community living services? These are all valid questions and concerns.

Let’s take the example of Chandigarh. By various estimates and surveys, the need for assisted living facilities for persons with mental disabilities is approximately 400-600 people (men and women belonging to different socio-economic strata). However, not all of them need it at once. The immediate need would be roughly 100-150 people; others would need it in the future as their parents and/or caregivers become very old. What could be the practical models for community living in Chandigarh? It’s important to understand that the needs and requirements of persons with mental disabilities vary. So there is no one way or the perfect model. Also, every model has its advantages and drawbacks, just as with everything else in life. To begin with, in Chandigarh, there could be 8-10 large houses spread across the residential areas in different sectors, or have some large suitable campus where different needs and requirements can be met; or perhaps a combination of both approaches.

In terms of management and funding, it would be easier and cost-effective to provide different services in one campus. It is important to ensure that the place is open and accessible, embedded in the city, and doesn’t give an institutional look. 

CASE FOR INDIRA HOLIDAY HOME

Over the years there has been a growing need for setting up assisted-living residential facilities for persons with mental disabilities, particularly those with chronic mental illness or intellectual disability, rendering them incapable of living independently. It is requested that such a facility be created in Indira Holiday Home, Sector 24.’ Dr Savita Malhotra, Ex-Dean, PGI

Indira Holiday Home is a charming, large and green campus that is just perfect for community living of persons with mental disabilities. Over the last three months, over 50 people (parents, siblings, mental health professionals, special educators and concerned citizens) have sent emails to the UT Administration, requesting for the conversion of Indira Holiday Home into an inclusive community village, where old people and persons with mental disabilities could live together like a symbiotic community. Dina Singh, a parent

Vocational training in sewing, embroidery, candle-making and spice packaging can be offered. Other activities such as gardening, horticulture, crafts and bakery can also be done. Additionally, a team of mental health professionals and social workers/NGOs can be formed to chalk out a management plan. Funds can be raised through individual donations and CSR. Kamal Malhi, meditation teacher

With its large campus and built-up facilities, it can be easily converted into an excellent place for community/assisted living for persons with psycho-social disabilities. Madhu Sarin, architect-cum-development planner

Being a large space, it can easily be used for multiple programmes like old age home also. Green spaces are calming for people with mental disability and thus this place matches well with the requirement. Dr Harkamal, counsellor

Chandigarh is unfortunately woefully lacking in decent assisted living facilities for persons with mental disabilities. It is still stuck in a 19th century mindset when it comes to residential facilities for persons with mental disabilities. The conversion of Indira Holiday Home into an inclusive community living space may not solve the entire problem, but it will be a substantial solution. More importantly, it will help break social and mindset barriers Poonam Natarajan, ex-chairperson, The National Trust, India